Author: mpew

The workers’ compensation system is often seen as a fossilized benefit delivery system, with medical care provided by the lowest bidder, administered by Luddites, and adjusted by overwhelmed claims adjusters, all driven by ’attorneys' misplaced incentives. On the other hand, I see extraordinary people doing what they can to make the system work, focusing on what they can do to ensure injured workers are properly taken care of. An excellent…

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Introduction Distractions in the workplace pose a significant challenge to risk managers focused on preventing accidents and ensuring safety. Distractions can be visual, manual, or cognitive, each type posing unique risks to individuals and organizations. This paper explores the nature of these distractions, provides real-world examples, and offers practical solutions to mitigate their impact. Types of Distractions Visual Distraction: Involves taking one's eyes off the task at hand.  Manual Distraction:…

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Defense attorneys have traditionally focused on individual claims management in workers' compensation, primarily centered around injury, compensability, permanent disability, and future medical care. However, with artificial intelligence and data analytics, there is an opportunity to refocus defense attorneys' role to address broader systemic issues and achieve improved claims outcomes, including injury prevention. Artificial Intelligence and Data Analytics Artificial intelligence and data analytics offer new opportunities to gather insights from deposition…

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The workers’ compensation claims settlement philosophy has a significant financial impact on injured workers and their employers. In addition to the economic issues, the nature of the workers' compensation settlement with an injured worker can also significantly impact the worker's success in moving beyond the injury and productively returning to work. For the past four decades, employers have been subject to a de facto settlement philosophy without fully understanding all…

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Uses of Claims Reserving The rating bureaus use case reserves to help determine the pricing of workers' compensation insurance. This calculation uses the case reserves on the claim files 18 months after the insurance policy's inception. Actuaries rely on claims reserves to help determine the projected ultimate cost of the claims. They calculate a reserve loss development factor applied to the cash reserves. Their calculations use industry trends, paid losses,…

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